| The Family Counseling Center Of Fulton County Inc | |
|
11-21 Broadway Gloversville NY 12078-3968 | |
| (518) 725-4310 | |
| (518) 725-2556 |
| Full Name | The Family Counseling Center Of Fulton County Inc |
|---|---|
| Speciality | Counselor |
| Location | 11-21 Broadway, Gloversville, New York |
| Authorized Official Name and Position | Michael Countryman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5187254310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Family Counseling Center Of Fulton County Inc 11-21 Broadway Gloversville NY 12078-3968 Ph: (518) 725-4310 | The Family Counseling Center Of Fulton County Inc 11-21 Broadway Gloversville NY 12078-3968 Ph: (518) 725-4310 |
| NPI Number | 1164473831 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 04/27/2018 |
| Medicare PECOS PAC ID | 0042283335 |
|---|---|
| Medicare Enrollment ID | O20040816000523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164473831 | NPI | - | NPPES |
| 01384734 | Medicaid | NY |
| Provider Name | Alfred Sorrentino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962695809 PECOS PAC ID: 8426105305 Enrollment ID: I20090410000003 |
| Provider Name | Kimberly L Tambasco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184839649 PECOS PAC ID: 9335166636 Enrollment ID: I20120625000610 |
| Provider Name | Michael Norman Divak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508284704 PECOS PAC ID: 9638476401 Enrollment ID: I20160322000705 |
| Provider Name | Edward P Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316311699 PECOS PAC ID: 6002113859 Enrollment ID: I20170720001060 |
| Provider Name | Christopher John Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356876684 PECOS PAC ID: 1355607565 Enrollment ID: I20171103001255 |
| Provider Name | Jennifer Lynn Rivenburgh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952962185 PECOS PAC ID: 0648605113 Enrollment ID: I20200113000187 |
| Provider Name | Heather Lynn Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891158390 PECOS PAC ID: 7214364397 Enrollment ID: I20200302001925 |
| Provider Name | Ashley Marie Ellenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407461411 PECOS PAC ID: 2860802519 Enrollment ID: I20201109000360 |
| Provider Name | Amanda Ellen Allie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699370452 PECOS PAC ID: 2769895408 Enrollment ID: I20210119001985 |
| Provider Name | Shameka L Bolton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568700029 PECOS PAC ID: 9032330675 Enrollment ID: I20210429001065 |
| Provider Name | Kathleen Landry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831761766 PECOS PAC ID: 4183014723 Enrollment ID: I20211214001032 |
| Provider Name | Lyndsey Gates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669130258 PECOS PAC ID: 7214323823 Enrollment ID: I20220407001975 |
| Provider Name | Julie Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093468050 PECOS PAC ID: 4688047400 Enrollment ID: I20230227000993 |
| Provider Name | Lara Malatesta Ware |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417642067 PECOS PAC ID: 5698120848 Enrollment ID: I20231009002283 |
| Provider Name | Gillian Farrell Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871271551 PECOS PAC ID: 1456709716 Enrollment ID: I20231127002011 |
Family Counseling Center Of Fulton County Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11-21 Broadway St, Gloversville, NY 12078 Phone: 518-725-4310 Fax: 518-725-2556 | |
Jackson Psychological, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 29 W Fulton St Ste D, Gloversville, NY 12078 Phone: 518-313-6105 Fax: 518-205-7520 | |
Fulton County Mental Health Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 73 N Main St, 3rd Floor Suite 302, Gloversville, NY 12078 Phone: 518-773-3532 Fax: 518-773-4003 | |
The Family Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11-21 Broadway St, Gloversville, NY 12078 Phone: 518-725-4310 | |
The Family Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11-21 Broadway St, Gloversville, NY 12078 Phone: 518-725-4310 | |
The Family Counseling Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11-21 Broadway St, Gloversville, NY 12078 Phone: 518-725-4310 |